Wednesday, September 28, 2011

Caring. Intensively.

He reminds the doctor of Stephen Hawking, his head leaning unsupported against the large chair. They were sitting him out of bed to avoid pressure sores.

He was a graphic designer before all this happened. Ten months of inexplicable, progressive weakness had brought him to a neurologist in country Victoria who decided he needed an MRI.

It was the radiologist who picked up on the MRI scanner that this gentleman was so weak he was not supporting his airway, and who knows how long he was obstructing for before they found him and put a tube down his throat and hooked him up to a breathing machine.

He had been in intensive care for many days now, his breathing dependent on the ventilator working faithfully next to him. A tracheostomy tube sticks out of his neck awkwardly, and the rest of his body is like a roadmap with lines sticking out from his neck, nose, wrists and bladder, translating signs of life into measurable numbers.

The doctor looks at him and all he can see is his patient. He sees the diagnoses that is yet to be made, he sees the tests that need to be ordered, he reads the numbers on his charts that tell him the patient does not have a fever, that his blood pressure was holding and that his blood counts were all normal.

The patient was quite drowsy for the first few days, but he was more awake now. In a terrible way, he was alive, yes, but he was being kept alive. The tracheostomy tube keeps his lungs working, his nutrition is delivered by a nasogastric tube going into his stomach, his bladder drains into a bag without him having to stand up in a toilet. He is unable to communicate because of the tracheostomy tube - breathing takes priority over speaking for now.

He is understandably frustrated, a prisoner to the illness keeping him here, but instead of bars, there are hospital curtains and railed beds; instead of  prison wardens there are the watchful doctors and nurses. He has pulled out his nasogastric tube countless times in protest, much to their dismay.

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The doctors and nurses have tried to be creative in helping him communicate. There is an electronic board with all the letters of the alphabet, and objects ('Doctor', 'Nurse', 'Toilet') and also a small whiteboard and marker when the electronic fails.

The gaggle of doctors stood over him patiently yesterday evening as he looked like he was desperately trying to communicate something to them.

'Count. My. Head. 1. 2. 3. 4.' was the repeated message after half an hour, almost eerie in its mystery.

The doctors tried to probe for a meaning, but the patient finally dismisses them with a roll of his eyes and a wave of his hand when he realised he wasn't getting through to them.  It soon became apparent to the doctors that he was confused, and so they started him on some anti-confusion medications.

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"He's pulled out his nasogastric tube while I was at dinner," says the nurse, exasperated.

It was a Sunday evening. Big band music crooned gently from the radio that they had placed next to him to drown out the monotonous beeps and bells of the machines surrounding him. The morning nurses had reported that he seemed less confused to them today.

The doctor walks up to him and says "Look, Michael, I know that it is a terrible thing to have that tube put into your nose and down the back of your throat, but while you're on this tracheostomy tube, there's no other way of getting some food into you. Do you understand?"

Michael's eyes pulled up almost defiantly at him. He motions for the electronic board.

"H. O. W. M. U. C. H. D. O. I. C. O. S. T." came the message from his weakened arms.

The doctor is puzzled by this almost existential question. "I'm sorry Michael, how much do you cost? As in how much does it cost to keep you alive? Well, you are in intensive care, Michael,  and it is quite exp..."

No, he shakes his head.

"H. O. W. M. U. C. H. D. O. U. C. O. S. T."

He taps on the 'Doctor' button.

"Oh, how much do I cost? Well. Michael," the doctor starts, uncertain how to answer him, "The government pays for me to look af..."

Michael starts pointing to himself and then to the doctor.

"H. O. W. M. U. C. H. D. O. U. C. O. S. T." Point. Point.

The doctor thinks he is still a little confused, and sighs - "I'm sorry Michael, I don't quite understand what you mean. I know it's fr...."

Suddenly it dawns upon the doctor what Michael was trying to say, and he breaks into a smile.

He turns to the nurse and says, "Sister, I am not sure if I am reading this correctly, but I think that Michael here is trying to bribe me."

Michael's face bursts into a large smile, nodding he had guessed right. The nurse bursts out into laughter and the doctor is taken aback by this unexpected joke.

"Well, Michael, I don't think you can afford him really," chirped the nurse, mock-chidingly.

Something shifted in the air that evening. The doctor notices out of the corner of his eyes the subtle movement of Michael's foot tapping along to the rhythm of the big band swing. The nurse even managed a little jiggle to the music as she walked past him, causing him to smile widely again.

Although his face scrunched a little from the discomfort, there was minimal resistance from Michael this time as the doctor fed the tube through his nose again.

The doctor waits for the nurse to leave, looks both ways and then leans down to Michael, and whispers conspiratorily into his ear - "For 50 dollars, I will break you out of this joint. How about that?"

Michael gasps a silent chuckle, and nods enthusiastically. For a few minutes, he feels human again.

Sunday, September 11, 2011

The Plane Heard Around The World

I was at work yesterday, and a big part of our work actually involves documentation. A few times during the day, many workers - be they doctors, nurses, ward clerks or visiting policemen - would write down the date, and suddenly reel a little in realisation, almost all eerily saying the exact same thing -

'Oh, has it been ten years already?'

September 11 2001. A day forever etched into our collective memories, as citizens of the world.

Whether American, Australian or Malaysian or wherever it is we call home, everyone remembers where they were the day the two planes crashed into The Twin Towers.

My consultant remembers how he had just welcomed his newborn son into the world a week ago to the day. He knew that something was wrong when he switched on the television that morning and every single channel was showing the same thing.

Some of us were kids when it happened. A policeman remarked how he was in Year 8 (fourteen) when it happened, and woke up oblivious to how the world had changed as he slept, but knew something was wrong when he heard all his classmates talking about the 'terrorists'.

We were sitting at home that day, the family watching TV over dinner. Dad was in charge of the remote control and was lazily surfing the channels on our satellite TV when he stopped on CNN. We watched curiously as there was breaking news about how a plane had accidentally flown into one of the Twin Towers in New York.

We all sat up, curious window onlookers of what was happening halfway around the world from us. We had assumed all we were seeing was some misguided pilot who had flown a little too low, into the path of a tall building. An unfortunate accident.

We were still trying to process what we were seeing from the cameras trained upon The Twin Towers, when the second plane hit.

We couldn't believe our eyes, and curiosity gave way to fear as it dawned upon us that what we were seeing was no accident.

We continued watching, mouths wide open, as the buildings started to collapse slowly. The images of people jumping off the buildings or the gray cloudstorm of destruction engulfing the fleeing New Yorkers below will be forever etched in my memory.

Everyone at work remarked how surreal it was - as if they were watching a movie.

I remember my little sister, sixteen then, watching the TV, her fearful tears streaming as the carnage unfolded before us, helpless witnesses to a day that changed the world forever.

Hope and Security seemed to crumble along with the two towers. It seemed that today, some ten years ago, the bad guys had won.

Friday, September 9, 2011

Extra! Extra! Read All About It!

One of my favourite habits as a young teenager before afternoon school session started was to lounge around the house in the morning reading the newspapers over breakfast.

We used to have the New Straits Times (NST) delivered daily to our doorstep. It was the more serious of the available newspapers in Malaysia, kind of like The Age or The Australian, and about the same layout and size.

There is something nostalgic about the feel of the newspaper spread in your hands - the rustling noise as you turn the pages or fold it over your lap, the way your thumbs darken by the ink rubbing off on your hands and, of course, that oh-so-satisfying crackling noise it makes as you snap-straighten the paper.

Reading the newspapers was a habit we picked up from Dad. It was a morning ritual for him - Dad in his wheelchair, newspaper in hand, breakfast at arms' length. He would always be reading the main news while we picked up the lifestyle and sports sections.

One day, out of nowhere, Dad made this stunning observation of our newspaper reading habits.

'You boys ah! Only read comics and stories about people being raped or sex stories only! Read something else lah!'

I glanced up slowly from my newspaper with a disinterested Yeah, whatever, Da-a-ad look but deep down I was like Shit! He's got us figured out! Quick! Read something important like, uh, the financial news!

I must say it was a scarily accurate description about what we were actually reading in the newspapers, but hey, what would you expect from an apathetic teenager whose only concern were his raging hormones and his second childhood?

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The comics were the only reasons for newspapers to exist, as far as we were concerned. Sometimes I wish we could just throw away the rest of the newspaper, or that it was just one big comic newspaper.
I had a peculiar habit when it came to reading my comics. After familiarising myself with the comics in the NST through the years, I would always read what I thought were the less-funny comics first and saving the funny ones for the last. So my eyes would travel in a rehearsed way, first over Peanuts, Ferd'nand,  Blondie, Bringing Up Father and a few others, before finishing up with Baby Blues and The World of Lily Wong.

Sunday was always our favourite newspaper day because it meant an entire pull-out of comics - all in colour! Luxury!

We switched over to The Star a few years ago, a more compact, easy read (think Herald Sun, but classier) and I think they have a better collection of comics, epitomised by the one I will always save for last:



Random Memories: Twenty Two Years Old

I remember distinctly the trip to the hospital for the MRI – I was sitting outside the MRI room, and all my personal belongings which would interfere with the functioning of the MRI machine were taken away from me (apart from my magnetic personality).

The waiting area for the MRI had all the cheer of your typical hospital – immaculately white walls, the token potted plant (which had the effect of brightening up the place like a weed in a graveyard), and the severely expired magazines which sat on the single table next to the mass of waiting chairs.

One warm soul however, had brought an item of hope into that reading table – there was a scrapbook filled with the eternally optimistic comic Rose is Rose cut out from the weekend editions of the local newspaper.

It looked to be a labour of love, as it must have taken someone months to years of patience to compile it and to leave this little gesture in the hospital to cheer the hearts of worried patients.

I read it with a thankful heart, discovering love and hope in this time of uncertainty.